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Wellmark extends COVID-19 benefits through August 31

Extension provides additional protection for members, employers and providers

Updated: May 27, 2020

Several weeks ago, Wellmark announced numerous temporary coverage updates related to the novel coronavirus outbreak. Since then, the effects of the outbreak have continued to evolve in many ways. It is evident that the coronavirus not only has the potential to affect the health of the members and communities we serve for some time, but also their finances. Therefore, Wellmark is announcing an extension of coverage updates that will continue to allow people to get the care they need.

The following is being extended from June 17, 2020, through Aug. 31, 2020, for Wellmark's fully-insured and Medicare Supplement members. Wellmark is working with self-funded groups that want to extend similar benefits for their members.

Coronavirus-Related Coverage Updates
Members Covering COVID-19 tests and related services — Members have no cost-share for appropriate testing and related services to diagnose or detect COVID-19.
Covering inpatient treatment — Members' cost-share (copay, coinsurance and deductible) related to inpatient treatment of COVID-19 with an in-network provider will continue to be waived.
Encouraging virtual visits — Wellmark members have access to virtual health care visits for all appropriate medical and behavioral health visits with no cost-share. For those who don't have a health care provider, please use an in-network provider. Telephonic visits are allowed when audio/visual capabilities are not accessible.
Increasing access to prescription medications — Wellmark prescription drug benefit plans allow for an early refill. We are also ensuring formulary flexibility if there are medication shortages or other access issues. Members are not liable for any additional charges if they receive a non-formulary medication as a result of a shortage of their current medication.
Extending accidental dental benefit — In recognition that dental procedures have been delayed due to the pandemic, treatment windows for accidental dental injuries are extended by 90 days or until Aug. 31, 2020, whichever is later.
Employers Helping businesses keep coverage for furloughed or laid-off employees — Wellmark is working with group customers to help them keep health insurance coverage for employees who may been furloughed or laid off.
Health Care Providers Providing the same reimbursement to providers for virtual visits — Wellmark's Iowa and South Dakota network providers will continue to receive the same fee for virtual visits as an in-person visit. This applies to all appropriate medical and behavioral health virtual visits with an in-network Wellmark provider.

If you are a Wellmark Medicare Supplement member, please visit Medicare.gov External Site to learn what is covered related to your COVID-19 health care needs. As your supplemental carrier, Wellmark will continue to pay for out-of-pocket expenses according to your policy related to Medicare covered services, such as deductibles, copays and coinsurance. Visit your prescription drug plan’s website (YourMedicareSolutions.com/Covid-19 External Site or JourneyRxMedicare.com/Covid-19 External Site) to see specific information about drug coverage related to coronavirus.

Answering member questions

Yes. Members have no cost-share for appropriate testing and related services to diagnose or detect COVID-19. This is required by the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act and remains in place as long as we are in a public health emergency, as declared by the federal government.

Wellmark will waive early refill limits on maintenance medications (consistent with members’ benefit plans). We also will ensure formulary flexibility if there are medication shortages or other access issues. Members will not be liable for any additional charges if they receive a non-formulary medication as a result of a shortage of their current medication.

Wellmark does not cover quarantine-related costs for COVID-19. However, medical-related expenses will be covered if needed during quarantine.

If you are experiencing a fever or acute respiratory symptoms (cough or shortness of breath), or have been in close contact with someone who has tested positive for COVID-19, please call your healthcare provider before going to a doctor's office, clinic, urgent care or emergency department. During that call, your provider will assess your symptoms and direct you to the right care.

Get a list of responses by doctors and hospitals in Iowa and South Dakota.

If you have an individual plan, send an email to IndividualBilling@wellmark.com Send Email, including your full name and subscriber ID. Please state you are unable to pay premiums due to COVID-19. A billing representative will reach out to collect further information and work to ensure benefits remain active.

If you are a business, please email us at the appropriate address noted below. Please include your group ID, subgroup ID and group name. Please state you are unable to pay premiums due to COVID-19. A billing representative will reach out to collect further information and work to ensure benefits remain active.

Limit the spread of COVID-19

Get tactics for protecting yourself at home, at school and in the workplace.

  • Clean hands often and limit handshaking
  • Disinfect surfaces you touch frequently
  • Hold meetings virtually and rearrange travel when possible
  • Know when to stay home

See the CDC's recommendations.

Get the guide External Site

Know if you're high risk

If you are in a high risk group, you should take extra precautions to protect yourself.

Who is considered high risk?

  • Older adults
  • People who have serious chronic medical conditions, such as heart disease, diabetes or lung disease

Learn more External Site

Find a doctor

Search for a provider, hospital or clinic for you or your family member. Log in to myWellmark to make sure the doctor and facility is in your network.

Find a Doctor External Site

BeWell 24/7

BeWell 24/7 connects Wellmark customers with real people who can help with a variety of health-related concerns no matter the time or day. Just call 24 hours a day, 7 days a week.

Get insights from BlueSM on coping with work and lifestyle changes, plus tips for staying healthy.

Doctor On Demand

Doctor on Demand External Site offers virtual visits with board-certified physicians for a number of minor issues, from a run-of-the-mill cold or flu to headaches, skin conditions or bronchitis. Physicians can even prescribe medication, if needed.

Wellmark is monitoring the virus

Wellmark continues to use the World Health Organization (WHO) External Site, the Centers for Disease Control and Prevention (CDC) External Site, Iowa Department of Public Health (IDPH) External Site, and South Dakota Health Department External Site as our official sources of information. For the latest U.S. impacts of COVID-19, please see the data reported by the CDC.

Doctor On Demand is a separate company providing an online telehealth solution for Wellmark members. Doctor On Demand® is a registered mark of Doctor On Demand, Inc.